Study on the application of enhanced recovery after surgery concept in perioperative management of acute appendicitis in children

This is the authors' abstract. We don't add key points for this paper.

This study aims to evaluate the impact of an enhanced recovery management program on the emergency treatment of acute appendicitis in children. The goal is to enrich management strategies for enhanced recovery after surgery in pediatric acute abdomen cases and to facilitate its wider adoption. We conducted a prospective study on pediatric patients with acute appendicitis who underwent emergency surgery at Nanjing Medical University Children's Hospital between July 2022 and February 2024. Patients were divided into an enhanced recovery (ERAS) group and a traditional (TRAD) group based on their admission dates. We compared hospital stay length, time to bowel movement, complication rates, readmission rates, pain scores, hospitalization costs, and family satisfaction between the two groups. Additional comparisons included white blood cell count, neutrophil percentage, C-reactive protein (CRP), and interleukin-6 (IL-6). A total of 156 patients were ultimately included in the study. Data from 99 patients in the TRAD group and 57 patients in the ERAS group were analyzed. The ERAS group showed better outcomes in hospital stay length, time to first bowel movement, pain scores, family satisfaction, and changes in CRP and IL-6 levels compared to the TRAD group ( P < 0.05). No differences were observed in readmission rates ( P > 0.1). The enhanced recovery perioperative management program for acute appendicitis in children is safe and feasible. It effectively reduces perioperative stress and inflammation, alleviates postoperative pain, speeds up gastrointestinal recovery, reduces hospital stay and costs, and improves patient satisfaction without increasing postoperative complications or readmission rates.